POST GRADUATE PRACTICAL TRAINING APPLICATION FORM

Please Complete Application Form in Capital Letters

1. PERSONAL INFORMATION

Title (Mr./Ms/Mrs./ etc)………………………………………………………………..

Family Name ……………………………………………………………………………….

First/ Middle Name ……………………………………………………………………………….

Gender Male/Female……………………………………………………………

Nationality …………………………………………………………………………………

Birth Certificate Voter’s ID Driver’s License National ID

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Residential Address: (House Address etc.) Postal Address: (P. O. Box. )

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Your Email Address ……………………………….. Your Mobile Phone Number

Your Home Phone # ……………………………. ………………………………………..............................

Please Attach Three

Recent Passport

Photographs of

Yourself here.

2. ACADEMIC BACKGROUND

Secondary Schools Attended: From ( e.g. 1980) To (e.g. 2000)

I ……………………………………………………………….. ……………………….. ………………………………….

Ii ……………………………………………………………….. …………………………. …………………………………

iii……………………………………………………………….. …………………………… …………..……………………

2b. Give Details of Other Qualifications Beyond Secondary School:

Name of institution From (e.g. 1980) To (e.g. 1990 Certificates

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SOURCE OF INFORMATION ON MUMFORD INSTITUTE OF TECHNOLOGY

Web Site Publication Radio TV Advertisement

Please indicate publication/advertisement …………………………………………………………………………….

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EMPLOYMENT DETAILS (CURRENT/PREVIONS) RECORDS:

Dates Organization Position Salary

From To

3. SPONSORSHIP

Relationship of Sponsor to Applicant:

(Parent/Guardian/Employer/etc.)……………………………………………………………………………………………

Name of Sponsor:

……………………………………………………………Nationality………………………………………………………………...

Sponsor’s

Address…………………………………………………………………………………………………………………………………..

Sponsor’s Phone #.................................................... Email Address…………................................

IN CASE OF EMERGENCY WE SHOULD CONTACT

Name……………………………………………………………………………….. Relationship………………………………..

Address

Details…………………………………………………………………………………………………………………………………….

Telephone# ………………………………………………… Mobile # …………………………………………………………

Email……………………………………………………………………………………………………………………………………….

4. ENGLISH REQUIREMENT

Produce English Proficiency Results…………………………………………………………………………………………

Is English the Language used in your Education? Yes No

5. PHYSICAL CHALLENGE(S)

State any physical challenge (s) you may have. We need this information to enable us

accord you special care…………………………………………………………………………………………………….

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PROVIDE NAME AND ADDRESS OF TWO REFEREES

Full Name: …………………………………………………… Full Name: ……………………………………………….

Address: ……………………………………………………… Address: ……………………………………………………

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Tel #............................................................... Tel # …………………………………………………….

Email………………………………………………………… Email ……………………………………………………..

6. MINIMUM ENTRY REQUIREMENTS

Entry Requirements:

Post Graduate Engineers and holders of

BSc. In Electrical and Electronics Engineering

BSc. In Computer Engineering and Computer Science

BSc. In Physics

HND Graduates

Technical and Polytechnic graduates

Practical Training Courses:

ELECTRICAL COURSES

A) 1) Three Phase Electrical Power Supply Training

2) Single Phase Electrical Power Supply Training

3) A.C. Phase Control and SCR Training

4) Power Electronics Training

5) Electrical Safety Training

6) Electricity Training

7) Network Laws and Theorems Training

8) Fiber Optics Physics Training

DIGITAL COURSES

B) 1) Digital Logic Design Training

2) Digital and Analog Training

3) Digital Logic Training (TTL & CMOS)

4) Digital Electronics Training

5) Interfacing CMOS to TTL & TTL to CMOS

TELECOMMUNICATION COURSES

C) 1) Pulse Code Modulation Training

2) Digital Time Division (Mod. & Demod.) Training

Program Selection

Student should select the TRAINING you wish to pursue:

1ST training…………………………………………………………………………………….

2nd training ……………………………………………………………………………………

3rd training ……………………………………………………………………………………

4th training…………………………………………………………………………………….

8a. Pledge to abide by all the rules and regulations of Mumford Institute of Technology.

I pledge to abide by all the rules and regulations of Mumford Institute of Technology Ltd.

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Name Signature Date

8b. Mode of Delivery

Our Mode of delivery is campus based only. Future modes of delivery will be announced.

9. How to Pay Your (Non-Refundable) Application Processing Fees

Applicants Must Note That All Application Processing Fees Are Non-Refundable.

Application Processing Fees For Post Graduate Training Admission Are:

Ghanaian Students: GH 60.00 Foreign Students: $ 70.00

Note: Foreign Students applying from within Ghana must use current Forex Bureau buying rate

for the US Dollars.

Payment Instructions for Applicants in Ghana For those who download the Application Form from our Website you will need to pay

the Application Processing Fee when you submit it. Please follow the instructions below: 1. Go to any Ghana Commercial Bank branch in the country and Pay-in Your Application

Processing Fee into our Ghana Commercial Bank Account. The Bank Account Details are:

Name of Account: Mumford Institute of Technology Ltd.

Bank Branch: Ghana Commercial Bank Ltd.

Adenta

ACCOUNT NUMBER: 1471130001945

SWIFT CODE: GHCBCHAC

I declare and confirm that the information given on this application form is complete and

accurate. I submit that the University has the absolute right to void my application if it is found

that it contains false or inaccurate information.

Name: ………………………………………………….. Date: …………………………………

10. How to Submit or Deliver Your Completed Application Form For

Admission

Direct all inquiries and documents to:

Office of Admissions

P. O. Box LG 355, LEGON, GHANA

Delivery Location: Adenta On Aburi Road, After Old Adenta Barrier, Next to Mechanical Lloyd

Mumford Institute of Technology

Director of Admissions and Records

FOR FURTHER DETAILS CONTACT: TEL 0233 068 713 OR

0233 068 717

0243 068 713

Web: www.mit.edu.gh Email: admission@mit.edu.gh

info@mit.edu.gh

11. Important Notice:

All applicants must note that the acknowledgement of this application and supplementary

material do not constitute an offer of admission to study at Mumford Institute of Technology Ltd.

Successful applicants will receive letter of admission clearly stating the program of admission and

other important details. Applicants are further informed that materials received cannot be

returned.

Official Use Only

Amount paid GH………… Receipt#.................. Date…………………………….

Form Received by………………………………………. Date……………………………..

Accounts Dept ………………………………………….. Date…………………………….

GPA checked Accepted Denied Applicant Notified

Transcript Rcvd. Photographs Program Test Sample

Admitted Student ID #................................ Date……………………………